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Overview
Yemen’s health system has been severely damaged by more than a decade of conflict. Displaced health workers, damaged clinics, and severe funding shortfalls have left millions of people without reliable access to health care. Immunization efforts, like every other essential service, have suffered as a result. This briefing does not attempt to address that access crisis in full. It focuses instead on a second, distinct barrier to immunization, one that persists even in places where clinics are functioning and vaccines are free. The specific districts of southern Yemen studied here were chosen precisely because their health facilities are reachable and vaccines are provided at no cost, and yet most children still go unvaccinated. The reason is often fear, mistrust, and the power of who within the family gets to decide whether a child is vaccinated or not. Yemen is one of the countries with the highest number of unvaccinated children in the world, and conflict-driven damage to health infrastructure remains a central, well-documented cause of that gap nationallyi .
Roughly one in four Yemeni children has not received the full set of recommended vaccines, and 17 percent are classified as zero-dose children, meaning they have never received a single dose of vaccine. By comparison, in the United States, about 1% of children under two years old are zero dose. In response in 2024, the IRC developed a social and behavior change strategy built on two channels at once: equipping trusted members of the community, and engaging caregivers directly with practical tools to act on that trust. This briefing outlines that approach, the results it has produced, and what donors can do to help it reach more children. Alongside continued investment in access and health system strengthening more broadly. An independent survey conducted after the project ended found that children were substantially more likely to complete the full vaccination schedule when their caregivers trusted vaccines and believed they protect children, early evidence that the trust caregivers gain from this approach is tied to real vaccination outcomes.
